Worawalan Waratworawan, a senior researcher at Mahidol University, focuses on gender, sexuality, HIV/AIDS, and sexual health. Her work includes MSM chemsex research, COVID-19 impact on LGBT youth, interventions for migrant workers, mHealth for HIV self-testing, and cyberbullying prevention in Thai youth.

Background: Power relations in gay, bisexual and other men who have sex with men’s (GBMSM) hi-fun (chemsex) spaces are often linked to imbalances in financial, social and sexual capital. Although widely discussed, such power is often viewed as fixed. We aim to understand the unique dynamics of, and how norms shift power in, Thai hi-fun settings.
Methods: Focus groups (n=5) and in-depth interviews (n=6) (April-Sept 2024) included GBMSM in Thailand with experience of sexualized drug use, recruited from community organizations in Bangkok, Khon Kaen and Pattaya. Data were analyzed thematically.
Results: Participants (n=30) were aged 25-47 years, ten living-with-HIV, 18 gay, seven born outside Thailand. Most (n=23) had taken methamphetamine before/during sex in preceding 12-months, with fewer taking ecstasy/MDMA (n=14), ketamine (n=5), cocaine (n=5) and GHB/GBL (n=2). GBMSM can realize their sexual identities and desires free from conventional social structures in hi-fun spaces. However, these settings have unique power dynamics and rules governing acceptable behavior, transgressing which can threaten autonomy. GBMSM with multiple forms of capital (financial/social/sexual) enjoy significant power which can be harnessed to meet one’s needs. For example, men considered handsome and sexually dominant have extensive leverage around partner choice, sexual practices and access to drugs, even without financial resources. Conversely, men lacking such capital have less influence in hi-fun settings. Power in hi-fun contexts can be fragile, particularly when individuals exceed normative drug taking limits. “Hualok”, (defined as drug-related behaviour beyond what is situationally normative, including hallucinating/behaving strangely) is associated with rapid power loss. Experiencing “hualok” can lead to reduced ability to self-advocate, rejection from hi-fun communities and backlisting. Maintaining control is therefore vital in maintaining safety in hi-fun contexts.
Conclusions: Interventions should empower men with less capital. Novel approaches can focus effective communication and keeping within, and recognizing when individuals exceed, their preferred drug consumption limits.